Surgical management of the infant with coarctation of the aorta and ventricular septal defect

Clinical and cardiac catheterization data were collected from 39 infants with coarctation of the aorta and ventricular septal defect, 31 of whom were initially managed only by surgical repair of coarctation. Data were analyzed to determine mortality, morbidity, outcome and factors that might predict...

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Bibliographic Details
Published in:Journal of the American College of Cardiology 1992-07, Vol.20 (1), p.176-180
Main Authors: Park, Jeanny K., Dell, Ralph B., Ellis, Kent, Gersony, Welton M.
Format: Article
Language:English
Subjects:
Aortic Coarctation - complications
Aortic Coarctation - mortality
Aortic Coarctation - surgery
Aortic Coarctation - therapy
Biological and medical sciences
Cardiology. Vascular system
Congenital heart diseases. Malformations of the aorta, pulmonary vessels and vena cava
Constriction
Digoxin - therapeutic use
Female
Follow-Up Studies
Heart
Heart Septal Defects, Ventricular - complications
Heart Septal Defects, Ventricular - mortality
Heart Septal Defects, Ventricular - surgery
Humans
Infant
Infant, Newborn
Male
Medical sciences
Prognosis
Pulmonary Artery
Survival Rate
Treatment Outcome
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Summary:Clinical and cardiac catheterization data were collected from 39 infants with coarctation of the aorta and ventricular septal defect, 31 of whom were initially managed only by surgical repair of coarctation. Data were analyzed to determine mortality, morbidity, outcome and factors that might predict survival or the need for septal defect closure. Of the eight patients who did not require surgical treatment before 3 months of age, seven underwent coarctation repair alone at a mean age of 2.3 years. Of the 23 infants managed with coarctation repair alone, before age 3 months, 9 needed no additional surgical treatment and 6 required early and 8 required late repair of the ventricular septal defect. Seven infants underwent coarctation repair and simultaneous pulmonary artery bandnig and one eventually required debanding after spontaneous closure of the septal defect. The overall mortality rate in this series was 10.3% (mean follow-up time 5.7 years). Of 39 infants, 16 (41%) never required a second operation for ventricular septal defect closure. For patients who had only coarclation or coarctation repair with pulmonary artery banding at
ISSN:0735-1097
1558-3597
DOI:10.1016/0735-1097(92)90156-H